Cash America values its relationship with you and understands
any reservations you might have regarding sharing your personal information.

The form below provides you the opportunity to limit our ability to
share your information with any non-affiliated third parties or with any
affiliated companies within the Cash America family of companies, except as
permitted by law. By submitting your request, we will stop sharing your
information as soon as reasonably possible. If, in the future, you would like
to allow us to share your information for the purpose of finding you the best
products and services to meet your needs, please feel free to contact us in
writing.

To submit your Opt-Out Request, complete the following steps:

Step 1:

About Me:

My Name

First Name

Last Name

Last 4 of My Social Security Number

Step 2:

Submit My Choice:

By submitting my request I am instructing Cash
America not to share any of Your Infomation1 with non-affiliated
third parties or with any affiliated companies within the Cash America family
of companies, except as permitted by law.

1. Please refer to the Privacy
Policy for a definition of "Your Information"